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Experience in one centre using the buttoned device for occlusion of atrial septal defect: comparison with the Amplatzer septal occluder

Published online by Cambridge University Press:  19 August 2008

François Godart ,
Christian Rey ,
Charles Francart ,
Marie André Cajot ,
Georges Marie Brevière ,
Guy Vaksmann ,
Patrick Devos ,
Jean Michel Coullet  and
André Vincentelli
François Godart
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Christian Rey
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Charles Francart
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Marie André Cajot
Affiliation:
Service d'anesthésie, Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Georges Marie Brevière
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Guy Vaksmann
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Patrick Devos
Affiliation:
CERIM-Département de Biostatistiques, Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
Jean Michel Coullet
Affiliation:
Service des Maladies Cardio-vasculaires Infantiles et Congénitales,Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
André Vincentelli
Affiliation:
Service de Chirurgie Cardiovasctdaire, Hôpital Cardiologique, Centre Hospitaller et Universitaire de Lille, France
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Abstract

We report our experience using the buttoned device to close defects within the oval fossa and probe-patent oval foramens, comparing the findings with those obtained with the Amplatzer septal occluder. from 1992 to 1997, we used the buttoned device to close defects in 73 consecutive patients, 64 with defects in the oval fossa and nine with patent foramens. We compared this experience with a further series of 62 patients seen from 1997 to 1999 in whom the Amplatzer septal occluder was used. Successful implantation was achieved in three-quarters of those with septal defects in whom the buttoned device was used, in all of those in whom the buttoned device was used for patent foramens, and in nine-tenths of those in whom closure was attempted using the Amplatzer occluder. Immediate surgery was needed in 3 patients in whom a buttoned device was used, one because of embolization and two with residual shunts and a straddling device. Similar immediate surgery was needed to retrieve one embolized Amplatzer occluder. During follow-up, surgery was needed in a further 7 patients, all having had insertion of a buttoned device, because of atrial perforation in one and a significant residual shunt in the remainder. At late follow-up, the rate of complete occlusion was 69% in the patients in whom the buttoned device was used to close a septal defect, 100% when the buttoned device was used for patent foramens, and 95% in those treated with the Amplatzer occluder. Our experience shows that the Amplatzer occluder produced a significantly higher rate of occlusion for larger defects, and with a shorter fluoroscopy time than the buttoned device. The Amplatzer septal occluder, therefore, is our preferred device for closure of defects within the oval fossa.

Keywords

Atrial septal defectbuttoned deviceAmplatzer septal occluder
Type
Original Article
Information
Cardiology in the Young , Volume 10 , Issue 5 , September 2000 , pp. 527 - 533
Copyright
Copyright © Cambridge University Press 2000

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